8B.09

Abstract

Objective: Carotid baroreflex activation therapy (BAT) is a renewed therapy to treat resistant hypertension. Currently, the activation electrodes are implanted unilaterally, preferably at the right carotid sinus. However, information on the carotid baroreflex side dominance is still lacking in hypertensive patients. The aim of this study is to explore carotid baroreflex asymmetry in patients with resistant hypertension.FigureDesign and method: To this aim we performed carotid sinus massage (CSM) in 19 patients, who receive BAT for drug-resistant hypertension. CSM was repeated twice at the left and right carotid sinus in a random order and the greatest reflex is presented. The procedure was also performed in 19 patients with resistant hypertension and without BAT. In addition, a group consisting of 19 healthy, age-matched persons also underwent CSM to serve as a control. The same investigator performed CSM in all participants. An independent investigator repeated the procedure in the healthy control group. Systolic blood pressure, heart rate and total peripheral resistance were recorded before and during CSM. Results: The patients showed a greater drop in systolic blood pressure, heart rate and total peripheral resistance during right than during left CSM (see Table, p < 0.05), while the healthy controls demonstrated an equal drop in systolic blood pressure, heart rate and total peripheral resistance during left and right CSM. Remarkably, the patients had a greater drop in those parameters during CSM when compared to the healthy controls. Conclusions: The carotid baroreflexes in hypertensive patients showed side-dominance towards the right carotid sinus. However, no side dominancy has been demonstrated in healthy humans suggesting that this asymmetry may occur in the course of the hypertensive disease.